How are public engagement health festivals evaluated? A systematic review with narrative synthesis

The evaluation of public engagement health festivals is of growing importance, but there has been no synthesis of its practice to date. We conducted a systematic review of evidence from the evaluation of health-related public engagement festivals published since 2000 to inform future evaluation. Primary study quality was assessed using the Mixed Methods Appraisal Tool. Extracted data were integrated using narrative synthesis, with evaluation methods compared with the Queen Mary University of London public engagement evaluation toolkit. 407 database records were screened; eight studies of varied methodological quality met the inclusion criteria. Evaluations frequently used questionnaires to collect mixed-methods data. Higher quality studies had specific evaluation aims, used a wider variety of evaluation methods and had independent evaluation teams. Evaluation sample profiles were often gender-biased and not ethnically representative. Patient involvement in event delivery supported learning and engagement. These findings and recommendations can help improve future evaluations. (Research Registry ID reviewregistry1021).

Information Sources (describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and dates you will or last searched) The following databases will be searched for English language studies published from the year 2000 up to present: MEDLINE on OvidSP, Web of Science -core collection, Embase, and CINAHL. We will also hand-search the reference lists and complete citation tracking of eligible papers.

Inclusion Criteria
Evaluation of a single or multi-year public engagement festival. All empirical study designs will be included. Art, culture or science festivals which have an identified health-related activity and where the evaluation is of this element will be included. Studies including families or children and adults, will be included if the adult data can be separated or isolated. Studies should self-identify as a 'festival'. Only studies which are published from the year 2000 to current will be included, since most public engagement festivals have emerged in the last twenty years. Only studies published in the English language will be included.

Exclusion Criteria
Studies evaluating both a festival and other public engagement formats or several different festivals, where evaluation data of the health-related festival cannot be separated or isolated will be excluded. Studies will be excluded if they use festivals to recruit participants into studies or use festival attendees for involvement in policy, research or service planning and prioritisation rather than public engagement i.e. those festivals with no two-way dialogue element. Studies which use festivals purposefully as health interventions rather than for public engagement purposes will also be excluded. We will exclude festivals which evaluate the impact only on children or student and teacher participants. Festivals which are only religious, art or music-based i.e. have no health-related science or research remit, will be excluded. Condition, disease or problem being studied The evaluation of public engagement health festivals.
Definition of 'Public Engagement' Two-way dialogue between scientists and members of the general-public. We focus here on engagement in relation to health-related science and research, including medicine and applied health.
Definition of 'festival': A live event which engages the public in health-related science. The event is transient, provides a brief and concentrated focus on the topic and takes places in a specific place or region.

Patients/Participants/Population
Adult members of the general public i.e. citizens who are non-specialists and not in academia or teaching, who are attending / have attended the public engagement festival.

Intervention(s) or Exposure(s)
Health-related public engagement festivals.

Control or Comparator(s)
Not applicable.

Primary Outcomes
The review will identify documented outcomes e.g. awareness raising, and outcome measures employed e.g. attendance, to evaluate public engagement festivals. Main outcomes which may not have been explicitly stated, but were measured and reported e.g. reach, satisfaction, impact, will also be described. The review will also describe the evaluation methods used, for instance pre-post questionnaires, frequency counts or interviews to evaluate public engagement health festivals.

Secondary Outcome(s) Not applicable Data extraction (selection and coding)
Titles and/or abstracts of records retrieved using the search strategy will be screened independently by SM to identify study reports which potentially meet the inclusion criteria. The full text of remaining records will be retrieved and independently assessed for eligibility by SM. A random sample of 10% will be screened by LS or CC to check for consistency in application of the eligibility criteria. Any disagreement over study eligibility will be resolved through discussion between